The Lupus Center at JHH is uniquely situated to address clinical research issues through prospective follow-up of a large number of SLE patients. During Dr. Petri's FIRST award, issues addressed included the risk of future thrombosis and coronary artery disease associated with antiphospholipid antibodies, routine cardiovascular risk factors, and prednisone use. The Lupus Cohort has now been refunded by the NIH. The specific aims of the RO-1, although a continuation of the FIRST award work, now include an emphasis on disease activity and disability. Ongoing disease activity exposes patients to the side effects of corticosteroids. Over one-half of patients sustain permanent organ damage. Determination of predictors of disease activity should help to reduce unneeded corticosteroid treatment and allow institution of earlier treatment when it is needed.